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The VA System

The U.S. Department of Veteran Affairs (VA) is a much maligned (both fairly and unfairly) but critical organization. It is the second largest federal agency. The Department of Defense is the largest, so this shouldn’t be a surprise. It employs a little under 350,000 people to serve 5,124,168 enrolled veterans as of 2014.

There are essentially three parts of VA and they have very little interaction: VHA(health services), VBA(benefits) and National Cemetery Administration. To get benefits you need to contact one or more of them depending on what you are trying to get. Signing up with one agency will not get you signed up with the others. Annoyingly, you need to contact both VHA and VBA if you move so you don’t miss important correspondence. All benefits and eligibility for them are authorized by various laws and VA is bound to them. All eligibility decisions can be formally appealed. Everything is based on what can be proven through military records along with civilian medical records if they exist. It is a maze of bureaucracy. The very best way to deal with it is to start with a Veteran Service Officer (VSO).

A VSO is a person hired by veteran’s organizations such as VFW. You do not need to be a member of the organization nor do they ever charge for their services. There are links to several organizations that provide VSO’s to the left of this but it is not a complete list. Shop around and find one that seems to really understand the system. What you need to get started is your DD-214 (only if you are already separated they can help start the process while still on active duty) and if applicable giving the VSO access to your medical records so they can decide how to proceed on any disability claims. Whether or not you can qualify for disability, which opens eligibility to a lot of services that the VA can provide, as well as financial compensation, depends solely on what is in your records and medical evidence as to your current condition and how it affects your life. To get the most help you will need to sign a power of attorney so they can work on your behalf on issues related to the VA. Otherwise, you will be left to fill out forms and submit them on your own; you will also not be able to get information as quickly as a VSO can.

When I was moving through my medical retirement proceedings, I was sent to a VFW VSO and he let me know everything I would likely qualify for and got the ball rolling before my retirement was completed. He got my application for disability put in as well as enrolling me in the nearest VA hospital in the area I was moving to. He also started me in the vocational rehab program which is a phenomenal program, especially stacked up against the GI Bill as it existed in 1996. It also covers things that the GI Bill does not such as vocational evaluations.

I had always assumed that a service member would need a medical discharge or retirement to qualify for these benefits. That is not true! You also do not need to be a boots-on-the-ground combat vet injured in the line of duty to qualify for benefits. If you are active duty, you are considered to be on duty 24/7. If you are on active duty and develop epilepsy, as in my case, and is a chronic disability you can get rated for it. Even if the condition existed before enlistment and you still passed the initial medical exam (assuming you disclosed it - never lie about medical issues to the military or VA, it can bite you hard) and it got worse you can get compensation for what got worse. In my case, my service did not cause it, at least as far as I can tell, but it happened on active duty so it is service connected. You could be walking off base and get run over by a drunk driver and if there are any disabling conditions it could be considered as service connected. As long as your disability wasn’t caused by your bad behavior you can likely get it service connected. If your disabilities happened while driving drunk, for example, it will not likely lead to a service-connected disability. It does have to be chronic and disabling. An acute incident that caused no problems once addressed will not qualify. Reservists and National Guard members do not have the 24/7 on duty presumption since they typically spend so little time each month drilling.

Disabilities are rated from 0%-100%, some are capped lower than that, and are combined (not added together) using what is called the “whole-man system”. It is a system that is used around the world in both private and public disability insurance systems. The max combined disability is 100%. I will write more specifically about the system, obtaining disability benefits and pitfalls to avoid in another post.

Receiving a dishonorable discharge will keep you from any benefits. Other than that, even other than honorable discharges might qualify you for some services. A VSO can help here.

VHA has rules mandated to them for health care that can be a little tricky. It is not as simple as “I served one enlistment give me free health care for life”. Again, a VSO can help you know what sorts of services you qualify for. The simplest is if you have any service connected disability you can always get seen for that and any treatment your VA doctor thinks is appropriate for free. Your dependents(unless your spouse or child is a veteran or otherwise qualifies) do not get medical care from VA but there are some cases where they do qualify for CHAMPVA which is free insurance they can use in the private sector. Retirees and their families qualify for medical care through the DoD but that is outside the scope and control of VA.

There are 8 categories of vets that qualify for VA care called priority groups. Priority groups have nothing to do with scheduling, everyone is scheduled the same from my experience. If you fit into multiple priority groups, which many do, you will be placed in the highest group you are eligible for. Some vets will have co-pays but they are very low and only apply to some eligible vets and are means tested. If you have co-pays and private insurance you can use that to pay for it. I have read reports from vets on VBN that their private insurance assumes that you paid your deductible to the VA. It is a cheap way to meet your deductible.

This was a quick and dirty introduction to the VA system, I will write more in other articles as there is much more to add. The most important thing here is if you are a vet, take your DD214 and see a VSO and see what you might be eligible for.